Provider Demographics
NPI:1649756198
Name:CAMP, GARRETT W (FNP-C)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:W
Last Name:CAMP
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 MOORES LN
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-1841
Mailing Address - Country:US
Mailing Address - Phone:903-792-2777
Mailing Address - Fax:903-794-1927
Practice Address - Street 1:2011 MOORES LN
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1841
Practice Address - Country:US
Practice Address - Phone:903-792-2777
Practice Address - Fax:903-794-1927
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138083207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP138083OtherTEXAS BOARD OF NURSING